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Keeping the Plan You Like

HHS Secretary Kathleen Sebelius writes about a new regulation that will expand new consumer protections to all Americans with health insurance, moving us toward the competitive, patient-centered market of the future.

Throughout the health reform debate, the President has been clear that we should build on the insurance system we have, keeping the parts that work and gradually fixing the parts that don’t.

The Affordable Care Act is designed to let Americans keep their health insurance if they like it while adding important consumer benefits to give businesses, families and individuals higher quality care at lower prices and more control over their own care.

Later today, Labor Secretary Hilda Solis and I will announce the latest step we’re taking to implement the Affordable Care Act with the announcement of a new regulation that is a key part of this approach.

The new regulation will expand new consumer protections to all Americans with health insurance, moving us toward the competitive, patient-centered market of the future. This rule reflects the President’s policy that Americans should be able to keep their health plan and doctor if they want.

Here’s how the new rule will work:

Starting with health plan or policy years beginning on or after September 23, Americans with private health insurance plans will get some new consumer protections. For example, insurance companies will be prohibited from putting lifetime limits on your coverage. And they’ll no longer be able to cancel your insurance when you get sick just by finding an error in your paperwork.

Health coverage that was in effect when the Affordable Care Act was enacted will be exempt from some provisions in the Act if they remain “grandfathered” under a provision in the law. Under the rule issued today, employers or issuers offering such coverage will have the flexibility of making reasonable changes without losing their “grandfathered” status. For example, employers will be able to make some changes to the benefits their plans offer, raise premiums or change employee cost-sharing to keep pace with health costs within some limits, and continue to enroll new employees and their families.

However, if health plans significantly raise co-payments or deductibles, or if they significantly reduce benefits – for example, if they stop covering treatment for a disease like HIV/AIDS or cystic fibrosis – they’ll lose their grandfathered status and their customers will get the same full set of consumer protections as new plans.

The bottom line is that under the Affordable Care Act, if you like your doctor and plan, you can keep them. But if you aren’t satisfied with your insurance options today, the Affordable Care Act provides for better, more affordable health care choices through new consumer protections. And beginning in 2014, it creates health insurance exchanges that will offer individuals and small businesses better, more affordable choices.

For more information about this rule, read the fact sheet and the Q&A.